Combined Brucella melitensis and Staphylococcus aureus endocarditis in a patient with a prosthetic aortic valve with fatal outcome.
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Letter↗
Biomedical subjects
Aydin Karanfil
Publications and source records attributed to Aydin Karanfil.
Association between adenoidal-nasopharyngeal ratio and right ventricular diastolic functions in children with adenoid hypertrophy causing upper airway obstruction.
OBJECTIVE: Adenoid hypertrophy causing upper airway obstruction can cause cardiovascular complications, including pulmonary hypertension and right heart failure in children. Adenoidal-nasopharyngeal ratio (ANR) is a practical, non-invasive and reliable method to evaluate adenoid enlargement. Our aim was to evaluate a possible association between ANR and echocardiographic parameters of right ventricle. METHODS: Twenty-one children who were affected by upper respiratory obstruction symptoms due to adenoid hypertrophy were included in this study (male/female: 12/9; mean age was 6.0 +/- 1.5 years). ANRs were calculated as the ratio of adenoidal depths to the nasopharyngeal depths on lateral cephalometric radiographs. Pulmonary arterial pressures, right ventricular diastolic filling parameters (peak E, peak A, E/A ratio), right ventricular end-diastolic diameters, and left ventricular ejection fractions were measured using echocardiography both preoperatively and also 3 months after the operation. RESULTS: Preoperative pulmonary arterial pressure, E/A ratio, right ventricular end-diastolic diameter, and left ventricular ejection fraction values were 23.10 +/-3.43 mmHg, 1.01 +/- 0.20, 1.95 +/- 0.16 cm, and 69.43 +/- 3.68%, respectively. Postoperative pulmonary arterial pressure, E/A ratio, right ventricular end-diastolic diameter, and left ventricular ejection fraction values were 16.94 +/- 1.45 mmHg, 1.24 +/- 0.14, 1.72 +/- 0.15 cm, and 69.77 +/- 2.17%, respectively. There were significant differences between preoperative and postoperative pulmonary arterial pressures, E/A ratios, and right ventricular end-diastolic diameters (p < 0.01 for each), while left ventricular ejection fraction values did not significantly change after the operation (p > 0.05). There was a negative correlation between E/A ratio and ANR-Ba (p < 0.05, r = -0.44). CONCLUSION: ANR can give information about the right ventricular functions in children with enlarged adenoids causing obstructive symptoms.
Adenoidectomy↗
Association between mitral annular calcification and stroke.
It remains controversial as to whether mitral annular calcification (MAC) is an independent predictor of stroke. The aim of this study was to investigate whether there is an association between the presence of MAC and stroke or whether MAC is one of the predictive factors of carotid atheroma and therefore is a secondary risk for stroke. Fifty-six patients who had MAC demonstrated by echocardiography underwent carotid artery duplex sonography and computed brain tomography with various causes were enrolled in the study. They were compared with 58 control patients without MAC. MAC was defined as a dense, localized, highly reflective area larger than 5 mm at the junction of the atrioventricular groove and posterior mitral valve leaflet. Carotid artery stenosis was defined as lumen diameter narrowing exceeding 60%. Cerebral ischemia was detected by spiral tomography and was classified as infarction and lacunae. A significant association was found between the presence of MAC and carotid atheroma (P = 0.011), MAC and hyperechogen plaque (P = 0.034), and MAC and stenosis (P = 0.008). There was an association between the presence of carotid atheroma and cerebral infarction (P = 0.007). Logistic regression analysis revealed hypertension and diabetes mellitus were independent risk factors (P = 0.030, P = 0.034, respectively) for developing carotid atheroma. MAC was an independent factor for carotid stenosis (P = 0.029). MAC may not be a significant causative factor for stroke, but may be a secondary risk factor. A significant association between the presence of MAC and carotid artery atherosclerotic disease may explain the high prevalence of stroke in patients with MAC.
Adult↗